The Impact of Total Tumor Diameter on Lymph Node Metastasis and Tumor Recurrence in Papillary Thyroid Carcinomas

Nuray Can ¹, Buket Yilmaz Bulbul ², Filiz Ozyilmaz ¹

⁰Department of Pathology, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye.

Diagnostics (basel, Switzerland) +

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February 10, 2024

View abstract on PubMed

Summary

Total tumor diameter (TTD) greater than 10 mm is a significant predictor of recurrence and lymph node metastasis in papillary thyroid carcinoma (PTC). This finding aids in refining risk stratification and clinical management for PTC patients.

Area Of Science

Endocrinology
Oncology
Pathology

Background

The prognostic impact of multifocality and bilaterality in papillary thyroid carcinoma (PTC) remains debated.
Identifying additional prognostic parameters for multifocal PTC is crucial for accurate risk assessment.

Purpose Of The Study

To investigate the impact of total tumor diameter (TTD) on tumor recurrence and lymph node metastasis (LNM) in papillary thyroid carcinoma.
To clarify the role of TTD as a prognostic factor in PTC.

Main Methods

A single-center retrospective study included 706 patients diagnosed with PTC.
Total tumor diameter (TTD) was calculated as the sum of the largest diameters of tumor foci in multifocal tumors.
TTDs were analyzed using cutoff values of 10 mm and 20 mm.

Main Results

Perineural invasion (PNI) and TTD > 10 mm were significant risk factors for LNM.
PNI, TTD > 10 mm, TTD > 20 mm, and bilaterality were significant risk factors for recurrence.
Lymphovascular invasion (LVI) and TTD > 10 mm were independent predictors for recurrence; LVI and extrathyroidal extension (ETE) were independent predictors for LNM.

Conclusions

Considering TTD > 10 mm in recurrence risk models may improve clinical management.
A clinical approach incorporating multifocal PTMCs with TTD > 10 mm and unifocal PTCs with primary tumor diameter (PTD) > 10 mm is recommended.

Keywords:

bilaterality multifocality number of tumor foci papillary thyroid carcinoma perineural invasion total tumor diameter